Healthcare Provider Details

I. General information

NPI: 1740758770
Provider Name (Legal Business Name): DINA GUZMAN LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2018
Last Update Date: 11/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2532 E 6TH ST
TUCSON AZ
85716-4404
US

IV. Provider business mailing address

1649 N HOWARD BLVD
TUCSON AZ
85716-3253
US

V. Phone/Fax

Practice location:
  • Phone: 520-440-7487
  • Fax: 520-844-8075
Mailing address:
  • Phone: 520-440-7487
  • Fax: 520-844-8075

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number22251
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: